Application for registration as an Australian company under the Corporations Act 2001 117

Australian Securities &
Investments Commission
Application for registration as an
Australian company
Form 201
Corporations Act 2001 117
Use this form to apply to ASIC for registration of a company under the Corporations Act 2001.
Related Forms
208 - Notification of details of shares allotted other than for cash
207Z - Certification of compliance with stamp duty law
If there is insufficient space in any section of the form, you may photocopy the relevant page(s) and submit as part of this lodgement
Lodgement details
An image of this form will be available as
part of the public register.
Who should ASIC contact if there is a query about this form?
ASIC registered agent number (if applicable)
Firm/organisation
SWIZZ LIMITED
Contact name/position description Telephone number (during business hours)
([phone] )
MR.D.C.SANE/DIRECTOR
Email address (optional)
[e-mail]
Postal address
U 235, Broadway AVE, AUSTRALIA
Suburb/City State/Territory Postcode
WESTBEACH WESTERN AUSTRALIA 5024
1 State/territory of registration
I apply for registration of the company under the Corporations Act 2001 and nominate the State or Territory in which
the company will be taken to be registered.
WESTERN AUSTRALIA Give State or Territory
2 Details of the company
Does the company have a proposed company name?
Yes
If yes, the proposed company name is
SWIZZ LIMITED
Name reservation number (if any)
No
The company name on registration will be its Australian Company Number (ACN).
Tick the legal elements that apply
Pty. Ltd. Proprietary Limited No liability NL
ASIC Form 201 11 December 2012 Page 1 of 8

2 Continued ... Further details of the company
Is the proposed name identical to a registered business name(s)?
For business names registered before
28 May 2012 without an ABN.
Yes No
If yes, I declare that I hold, or am registering the company for the holder(s) of, the identical
business name(s), the registration details of which are listed below.
ABN
XXXXXxxxXXXX
or
Previous business number Previous state/territory of registration
Type of company Class of company Special purpose (if applicable)
proprietary company
public company
limited by shares
unlimited with a share capital
limited by shares
limited by guarantee
unlimited with a share capital
no liability
home unit (HUNT)
superannuation trustee (PSTC)
charitable purposes only (PNPC)
superannuation trustee (ULSS)
charitable purposes only (ULSN)
Special purpose company
Refer to Guide for descriptions of
special purpose companies.
A public company that is:
• a superannuation trustee, or
• for charitable purposes
only, must have a constitution.
Registered office
You cannot use a PO Box address
If this is a special purpose company, tick the box below to make the declaration.
I declare that this company is a special purpose company as defined under Regulation 3 of the
Corporations (Review Fees) Regulations 2003.
Governance of a public company
The company will rely entirely on replaceable rules
The company has a constitution
A proposed public company which has adopted a “Constitution” must lodge a copy of the constitution
with this application.
If the proposed company is to be a public company limited by guarantee, state the amount of the guarantee that each
member agrees to in writing.
The amount of the member’s guarantee is $ (insert amount)
At the office of, C/- (if applicable)
U 235, Broadway
AVE
Office, unit, level
Street number and Street name
Suburb/City WA- State/Territory 5024-Postcode
ASIC Form 201 11 December 2012 Page 2 of 8

2 Continued ... Further details of the company
Office hours
For a public company
Does the company occupy the premises?
Yes
No
If no, name of occupier
Occupier’s consent (Select box to indicate the statement below is correct)
The occupier of the premises has consented in writing to the use of the specified address as the
address of the registered office of the company and has not withdrawn that consent.
a. Registered office of a public company is open to the public each business day from at least 10 am to 12 noon
and 2 pm to 4 pm.
b. Registered office of a public company is open to the public each business day for at least 3 hours
between 9 am and 5 pm.
If b, insert hours open from am/pm close to am/pm
Principal place of business If same as registered office, write “as above”.
Office, unit, level
AS
AB
OV
E
Street number and Street name
Suburb/City State/Territory Postcode
Country (if not Australia)
3 Appoint officeholder
A public company must have a minimum
of 3 directors (2 resident in Australia) and 1
secretary (resident in Australia).
A proprietary company must have
a minimum of 1 director (resident
in Australia). The office of secretary is
optional, but if appointed one must
reside in Australia.
Officeholder(s) appointment date shall
be effective from the beginning
of the day on which the
company becomes registered.
Office held
Director Secretary
Family name Given names
SANE
Former name
D.C.
Street number and Street name
1024.......XYZ street
Suburb/City State/Territory Postcode
Ab
c
cit
y WA 5024
Country (if not Australia)
AUSTRALIA
Date of birth
1 0
/
1 0
/
8 3
[D D] [M M] [Y Y]
Place of birth (town/city) (state/country)
W
A
AUSTRA
LIA

ASIC Form 201 11 December 2012 Page 3 of 8